Primary Care Pharmacy March 2000 Vol 1 No 2 p50-51

Clinical governance and CPD – what it means for you

By Alison Astles, MRPharmS, DipPresSci

Every health professional is responsible for the quality of their service. CPD is a means of achieving higher standards

Recent Department of Health publications have put quality at the heart of NHS organisations. HSC 1999/065 "Clinical Governance: in the new NHS"1 sets a vision of clinical governance for the next five years and gives minimum targets for NHS clinical governance activity during 1999 and 2000. While much of the activity that will happen under the banner of clinical governance is not new, having a framework which insists on organisational support provides opportunities that should be taken advantage of by pharmacists. Continuing professional development is a key element of providing a quality service. HSC 1999/154 "Continuing professional development: quality in the new NHS"2 clearly lays down the personal and organisational responsibilities for developing CPD. In summary, this document says that training and development plans should be in place for most NHS health professional staff by April, 2000, that current arrangements for and investments in CPD should be audited and that a locally managed system of CPD should be developed. Team based and multidisciplinary learning is encouraged, as is linking of individual CPD goals to those of the organisation for which they work. In view of the requirements laid down in HSC 1999/154, a few practical pointers for reviewing personal CPD are given below:

Department of Health: quality must be at the heart of the NHS

Write it down

It is vital that pharmacists write down their CPD activities. CPD has to be demonstrable, and this is where many pharmacists seem to fall down. Accountability for performance is a crucial component of clinical governance, and it is important to be able to demonstrate CPD to others. A portfolio, for example, that produced by the College of Pharmacy Practice, is useful.

Assess your learning needs

You need to assess your learning needs. This is not always as easy as it sounds. As a start, use some of the techniques described below, such as reflective practice, risk assessment and the objectives of the employer organisation help to identify learning needs.

Learn from others

Effective learning from leading edge practitioners and services means being research-aware, and communicating and networking effectively. One of the best sources of learning is a peer group. On a practical level, if a pharmacist has not contacted another primary care pharmacist about something in the past week, they should make sure that they do so as soon as possible.

Team-based learning

An important message from the Department of Health is that learning should be team-based and multidisciplinary. Primary care pharmacists are well aware of the value of the primary care team as a learning forum and often take the lead.

Reflective practice

Practice should be reflective. Pharmacists often seem to think that this is more complicated than it really is. A simple way to get started with reflective practice is to think of a circumstance in daily practice that felt uncomfortable recently - perhaps a topic a general practitioner mentioned that little was known about or a meeting where the pharmacist was unable to contribute. Feelings of being uncomfortable often indicate an area to look at in more depth. Do not forget to learn from successes and to pick up on feelings of satisfaction to discover why things went well.

Risk assessment

Another clear message from clinical governance is the need to assess the risk involved in activities undertaken, and the ways of minimising these risks. As a start, think about activities undertaken and how they could potentially go wrong. What could be done now to prevent errors from occurring? This is also a useful way of identifying learning needs.

Make sure that there is sufficient time

Time is a pharmacist's most limited resource and is often given as the major barrier to effective CPD. Unfortunately, lack of time is not a good enough excuse anymore - no-one has enough. Negotiation and prioritisation are vital in making time available. The point of the new clinical governance agenda is that it is an organisational framework and an organisational responsibility. This gives pharmacists levers to negotiate their objectives within an organisation and ensure that effective CPD is one of those objectives.

Make use of information technology

Good information technology resources are essential. To meet learning needs, it is essential to have good access to information. Many pharmacists in primary care do not have a desk to call their own and few have the luxury of being able to sit in a library. So the library has to come to the pharmacist. If there is no access to the Internet and e-mail at work, this should be raised with managers, as soon it will not be possible to work without it.

Personal development plans (PDPs)

The majority of health professional staff should have PDPs in place by April, 2000 (HSC 1999/154). PDPs give pharmacists the opportunity to collate all personal clinical governance activity. Plans must meet the needs of the local population, as well as the personal and professional needs of the individual and have to be geared to the needs of the PCG and health improvement plans. An effective appraisal process is probably the best way of ensuring that this happens.

Miss Astles is a pharmaceutical adviser at Sefton health authority

References

Note: HSCs are available from the Department of Health website at http://tap.ccta.gov.uk /doh/coin4.nsf